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Alcoholic Dementia −Symptoms, Causes and Potential Treatment

Dementia is a gradual, persistent and progressive health condition associated with old age and the degeneration of the nervous system. Studies show this disease has a higher incidence from ages 65 to 90.

Since 74.7 million people are expected to suffer from dementia in 2030, causing significant implications for national health and social services, prevention strategies are imperative to halt its progression. Alcohol consumption has been linked to the cognitive decline of this disease and modifying drinking habits sits at the core of dementia prevention.

Continue reading to learn about alcoholic dementia, its symptoms, disease progression and its potential treatment.

What is Dementia?

The first and most important premise to clarify is that dementia is not a synonym for Alzheimer’s disease.

Dementia is not a specific disease but rather a general term for the progressive cognitive decline that interferes with the ability to function independently. It mainly causes difficulties in learned behaviors, memory thinking and decision-making. Alzheimer’s disease is the most common type of dementia.

Dementia signs vary in each individual, presenting cognitive deficits such as:

  • Amnesia (memory loss)
  • Agnosia (inability to recognize objects)
  • Apraxia (inability to perform previously learned tasks)
  • Aphasia (slurred speech)
  • Impaired executive function (reasoning, judgment and planning)

This cognitive impairment results from cerebral cortex injury due to synaptic failure, inflammation and changes in the brain metabolism.

Understanding Alcoholic Dementia (ARD)

Alcohol use disorders (AUDs) are among the most predominant mental disorders, contributing significantly to morbidity and mortality, particularly in younger people and women.

Among the health risks of alcohol abuse, heavy drinking is linked to a higher susceptibility to alcohol-related brain damage, causing alcohol-related dementia due to the toxic effects of alcohol on nerve cells and Wernicke-Korsakoff syndrome (WKS), which is characterized by a lack of vitamin B1 (thiamine).

Signs and Symptoms of Alcoholic Dementia

Diagnosis criteria for alcohol-related dementia are usually reserved for the clinician’s judgment, as symptoms may overlap with other types of dementia.

The most obvious reason would be a long-term history of alcohol abuse (i.e., a minimum of 35 standard drinks/week for males and 28 for women) for more than five years and a clinical diagnosis of dementia at least 60 days after the last alcohol intake.

The symptoms of alcohol dementia may be:

  • Significant impairment in short-term memory
  • Impaired rational, poor decision-making and problem-solving
  • Disorientation to time, place, or situation, difficulty in engaging in coherent conversations
  • Noticeable changes in personality, mood swings, increased sensitivity
  • Decreased empathy or social withdrawal
  • Difficulties in expressing thoughts or understanding verbal communication
  • Impaired motor coordination, slurred speech, difficulties in walking, balance or fine motor movements
  • Reduced awareness of the condition, poor adherence to treatment

Who is At Risk of Alcoholic Dementia?

Various risk factors contribute to the development of dementia, such as positive family history, repetitive head trauma, cardiometabolic factors (diabetes, hypertension, obesity and dyslipidemia), atrial fibrillation, sleep apnea and previous depression.

For alcohol dementia, these factors may play an important part, yet identifying who is most at risk and why deepens our understanding of this condition:

  • Long-term, excessive alcohol consumption
  • Older adults who drink heavily
  • Individuals with AUD due to chronic patterns of alcohol consumption
  • Certain genetic variations, in combination with heavy alcohol consumption
  • Preexisting medical conditions (liver and cardiovascular disease, diabetes)
  • Women may be more susceptible to alcohol-related brain damage and cognitive impairment
  • Socioeconomic factors can influence alcohol consumption and access to healthcare
  • Comorbidities, such as depression, anxiety or post-traumatic stress disorder (PTSD)

How to Diagnose Alcoholic Dementia?

Diagnosing alcohol-related dementia typically involves a series of assessments by a healthcare professional, which may include:

  1. Medical history to inquire about the alcohol consumption patterns, medical history and symptoms
  2. Physical examination to assess overall health and to identify any signs of alcohol-related complications
  3. Cognitive screening tests to evaluate cognitive function, including memory, attention, language
  4. Laboratory tests to assess liver function, nutritional status, vitamin deficiencies or thyroid dysfunction
  5. Brain Imaging (MRI or CT) to evaluate brain structural changes
  6. Assessment of Alcohol Use Disorder following the Diagnostic and Statistical Manual of Mental Disorders

Is It Alcoholic Dementia Reversible?

Magnetic resonance imaging (MRI) has shown moderate alcoholism causes mild cerebral atrophy and lower mean brain weight; most of this brain shrinkage is mainly attributed to white matter loss.

However, a hopeful assessment points out abstinence may improve motor abilities and cognition, reversing white matter shrinkage. But, if the drinking is resumed, the brain again becomes vulnerable to disruption and subsequent health risks.

Although research shows improved cognitive functions, it’s not a full recovery or 100% reversible.

Alcoholic Dementia − Treatment and Key Takeaways

As diagnosing alcohol-related dementia remains challenging due to the lack of specific diagnostic criteria, this can have significant implications for prognosis and treatment.

While alcohol-related dementia may be less progressive and potentially reversible compared to Alzheimer’s disease, patients should receive management strategies that address both cognitive impairment and alcohol misuse with long-term care in mind.

Leading a healthy lifestyle, including regular exercise and a balanced diet, can decrease the chances of developing chronic diseases and may contribute to reducing dementia rates. If you suspect someone may be suffering from alcohol dementia, offer support and help them to access the medical services available.

People Also Ask

What causes alcoholic dementia?

Alcohol-related dementia, also known as alcohol-induced neurocognitive disorder, is primarily caused by long-term excessive alcohol consumption, leading to brain damage, neuronal loss, and cognitive decline.

What is the life expectancy of someone with alcohol dementia?

According to a study, the five-year survival rate for someone with alcohol-related dementia is 53.4% for men and 63.4% for women. The 10-year survival rate is 29.5% for men and 38.3% for women. Exact life expectancy depends on a history of alcohol use, other substance use, age and other health concerns.

Does alcohol contribute to Alzheimer’s?

Research is still inconclusive about this correlation as some studies show that low drinking may reduce the chance of developing Alzheimer’s disease, while regular heavy drinking increases the probability. Other studies have found that moderate alcohol use can accelerate Alzheimer’s disease progression.


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Retrieved on April 12, 2024.

Published on: March 9th, 2018

Updated on: April 12th, 2024

María José Petit-Rodríguez

About Author

María José Petit-Rodríguez

Medically Reviewed by

Dr. Alison Tarlow, Certified Addictions Professional (C.A.P.)

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